Effects of midazolam and lidocaine on spectral properties of the EEG in full-term neonates with stroke

W. Jennekens, F. Dankers, F. Janssen, M. Toet, N. van der Aa, H. Niemarkt, C. van Pul, L. de Vries, P. Andriessen

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)

Abstract

Assessment of the neonatal EEG may be hampered by drug-specific changes in electrocortical activity. To quantify effects of a loading dose of midazolam and lidocaine on the EEG frequency spectrum of full-term neonates with perinatal arterial ischemic stroke (PAIS), 11 full-term infants underwent multi-channel amplitude-integrated EEG (aEEG) and EEG recordings. During recording, midazolam and/or lidocaine were administered as anti-epileptic drug. Retrospectively, we performed spectral analysis on 4-h EEG segments around the loading dose. The frequency spectrum was divided in δ (1-4 Hz), θ (4-8 Hz), α (8-13 Hz) and β (13-30 Hz) bands. Midazolam induced immediate suppression of the aEEG background pattern for 30-60 min. Spectral EEG analysis showed decreased total and absolute frequency band powers. Relative δ power decreased, θ power increased while α and β powers remained constant. Lidocaine induced no aEEG background pattern suppression. Total and absolute EEG band powers were unchanged. Relative δ power decreased, θ and α power increased and β power remained constant. Effects of lidocaine were more pronounced in the stroke-affected hemisphere. In conclusions, both drugs induced a shift from low to higher frequency electrocortical activity. Additionally, midazolam reduced total EEG power. These spectral changes differ from those seen in adult studies.

Original languageEnglish
Pages (from-to)642-652
Number of pages11
JournalEuropean Journal of Paediatric Neurology
Volume16
Issue number6
DOIs
Publication statusPublished - Nov 2012
Externally publishedYes

Keywords

  • Anticonvulsants
  • Brain Ischemia
  • Data Interpretation, Statistical
  • Electroencephalography
  • Epilepsy
  • Female
  • Functional Laterality
  • Humans
  • Hypnotics and Sedatives
  • Infant, Newborn
  • Infarction, Middle Cerebral Artery
  • Lidocaine
  • Male
  • Midazolam
  • Seizures
  • Stroke

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